As a midwife working in the hard-scrabble conditions of West Virginia during the Depression, Patience Murphy's only solace is her gift: escorting mothers through the challenges of childbirth. Just beginning in her profession, she takes on the jobs no one else wants, caring for those most in need--and least likely to pay. Patience is willing to do what it takes to fulfill her mentor's wishes, but starting a midwifery practice means gaining trust, and Patience's own secrets are too fragile for her to let anyone in--especially her neighbor, rugged veterinarian Daniel Hester.

A stirring piece of Americana, The Midwife of Hope River rings with authenticity as Patience faces seemingly insurmountable odds that threaten her at every turn, from the dangerous mines of West Virginia to the terrifying attentions of the Ku Klux Klan. But as her life becomes entwined with those around her, Patience learns to overcome the grief of her past and open herself up to different kinds of love--discovering a joy she never thought existed.

(from the back cover)

Patricia Harman, the author of The Midwife of Hope River, started as a lay midwife on the rural communes where she lived in the 1960s and ’70s. She went on to become a nurse-midwife on the faculty of three different colleges, and is a Certified Nurse-Midwife who makes presentations at midwifery conferences. She has written two memoirs about her experiences as a midwife, and she used her personal notes about the births she attended (and a bunch of research about the late 1920s and early 1930s) to write this novel.

The story is told by Patience in the first-person point of view, and it definitely “rings with authenticity” when it comes to the detailed births that she attends. WHEW! I really need to stop reading books that detail childbirth. It’s very interesting stuff, but…I just couldn’t handle it without squirming and sometimes having to put my head between my knees out of dizziness. I’m a total wuss when it comes to medical stuff in general, and childbirth in particular. I am also a glutton for punishment, it seems, and I have to admit that I was curious about what midwifery and home births were like 80 years ago. It is the mark of a good writer that I pictured the scenes so clearly and that they had such an effect on me. Kudos, Ms. Harman.

The Midwife isn’t just about childbirth, though, which is the other reason I was interested in reading it. It’s set against the backdrop of the Appalachians at the beginning of the Great Depression, so Harman also highlights the race and class tensions that were made worse by the failed economy. I’m not an expert on what it was like in West Virginia in the ’20s and ’30s, but this part of the book also rings true to me. I was a little leery of the premise before I started reading–the last thing I need to read is another inauthentic book about a white woman coming to the rescue of poor black people in the south. But I was interested enough to check it out, and I’m glad I did–Patience isn’t that woman, and The Midwife isn’t that book. Patience has had a rough life, and she moved to West Virginia with her friend and mentor after getting into trouble as a union-sympathizer and revolutionary in Pittsburgh. She already sympathizes with the poor and disenfranchised (and is poor, herself). While she starts out rather naïve about race relations in the south, she is open-minded and learns from her experiences. Harman doesn’t overdo it, so nothing about this part of the book feels forced or fake to me–I’m very impressed.

There are a few aspects of the book that I think Harman could have done more with. The relationship between Patience and Daniel Hester could have been fleshed out better; it feels…off…somehow. The ending of the book is kind of disappointing, too–I feel like Harman took the easy way out by leaving parts of the storyline hanging, when providing more detail and wrapping things up would have made the ending much stronger. Overall, though, I really enjoyed the story.

The Midwife of Hope River is a good first novel with an interesting storyline and well-written characters. I’d recommend it to anyone who is interested in learning more about midwifery; union struggles and mining conditions in the ’20s and ’30s; or race and class relations in West Virginia during that time.

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